Ongoing studies of oral physiology during speech and swallowing continue to indicate that ultrasound, a noninvasive dynamic imaging technique, can provide valuable data on oral motor performance. Because real-time ultrasound has no known bioeffects, we can conduct longitudinal studies on children and can examine our patients repeatedly without risk. We have begun to evaluate the oral performance of two groups of patients: 1) X-linked Hypohidrotic Ectodermal Dysplasia (X-HED), and 2) pre and post-menopausal women on estrogen replacement. X-LINKED HED: Patients are evaluated from a NICHD study, L. Russell, M.D., PI. Patients have complete or partial loss of teeth and deficient mucous glands in the respiratory and gastrointestinal tracts. These symptoms may impair food preparation, swallowing, and bolus transport through the digestive tract. We are using ultrasound to evaluate base line swallowing function and to determine whether dental implants will affect chewing and bolus transport over time. Twenty-one youths, ages 4 to 16 and 5 adults, ages 31 to 62 have been seen this year. Preliminary analyses of swallowing and chewing indicates that these patients have normal ability to swallow liquids but that duration of swallowing/chewing for solids is at lease double that of nonaffected persons. Tongue motion appear to be used to compensate for edentulousness. We will evaluate all subjects after dental/surgical procedures are completed to determine the validity of these preliminary findings. PRE-POST MENOPAUSAL FEMALES: Patients are referred from NIMH, P. Schmidt, M.D., PI. We are interested in determining the relationship between salivary flow and swallowing in females on hormone replacement therapy. Ultrasound studies are conducted in patients immediately after salivary flow samples are collected. Patients are studied prior to administration of estrogen, lupron or a placebo. Fifteen patients have been studied at baseline prior to treatment. Patients will be evaluated when the medication is at peak and again when it has been withdrawn. Preliminary results are not yet available as insufficient numbers have been studied on medication/placebo.